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Background: Neonatal blue light phototherapy (NBLP) has been widely and successfully used for the treatment of neonatal jaundice to reduce the plasma concentration of bilirubin and, hence, to prevent kernicterus. Only a few and controversial data are available in the literature as to how NBLP influences melanocytic nevus development., Objective: Our goal was to conduct a twin study with the aim of better understanding the role of NBLP in melanocytic nevus development. We also investigated the roles of other environmental and constitutional factors in nevus formation., Methods: Fifty-nine monozygotic and dizygotic twins were included in this cross-sectional study. One of the twin members received NBLP, and the other did not. A whole-body skin examination was performed to determine the density of melanocytic skin lesions. The prevalence of benign pigmented uveal lesions was evaluated during a detailed ophthalmologic examination. A standardized questionnaire was used to assess data relating to constitutional, sun-exposure, and other variables. To search for possible gene-environmental interactions involved in the appearance of pigmented lesions, the melanocortin 1 receptor variants and the I439V polymorphism of histidine ammonia-lyase genes were also determined in the enrolled twins., Results: NBLP was associated with a significantly higher prevalence of both cutaneous and uveal melanocytic lesions. No association was found between the examined gene polymorphisms and the number of pigmented alterations in the examined study group., Conclusions: Our data suggest that NBLP could well be a risk factor for melanocytic nevus development. Phototherapy with blue-light lamps is a standard and essential therapeutic modality in neonatal care; therefore, additional in vivo and in vitro studies are necessary to establish its potential long-term adverse effects.

Paravasation of cytostatic drugs during peripheral intravenous administration is a well known complication. In the United States of America it occurs in seven percent of cases with different severity and consequences. Although methods to completely avoid this complication are still unavailable, we are able to decrease the risks by identifying the patient- and procedure-related factors. The educated patient is a good indicator of paravasation in case he or she can cooperate and call the nurse. When the patient is unable to cooperate, the risks of extravasation is higher and closer nursing surveillance is indicated. The extent of injury depends mainly on the chemical structure of the extravasant substance (vesicant, irritant or non-vesicant) which may be modified by other factors. There is no strong evidence-based guidance for the management of complication. Abrupt cessation of the infusion and drawing back on the inserted venous catheter as well as elevating and resting the affected limb are necessary measures. In the available literature cooling or warming of the affected area is controversial. Similarly there are still open questions regarding the value of using antidotes as dexrazoxane, dimethylsulfoxide, thiosulfate and hyaluronidase (which is not registered as medicament in Hungary). In the event of extravasation early multidisciplinary dermatological and surgical assessment is essential for definitive diagnosis and setting the optimal management.

Unlabelled: Electrochemotherapy is an effective treatment of cutaneous and subcutaneous metastases in patients with malignant melanoma. During the treatment, electric pulses are applied to tumor nodules to deliver non-permeating or poorly permeating chemotherapeutic agents into the cells thereby increasing local cytotoxicity of anticancer drugs., Methods: In 7 patients 81 cutaneous and subcutaneous melanoma metastases were treated with electrochemotherapy. All treatments were performed under general anesthesia using intravenous bleomycin injection. Median follow-up was 218 days., Results: Complete response rate was 25%, partial response rate was 43%. We observed no change in 26%, and progressive disease in 6%., Conclusions: Electrochemotherapy is a simple and effective treatment of single or multiple cutaneous and subcutaneous metastases of melanoma, with minimal side effects. Our results confirm the results of recently published studies that the treatment used for palliation has clinical benefit and impact on the quality of life.

The authors present a 51-year-old patient with clinical signs of acrodermatitis continua suppurativa of the toes. Since histological findings failed to unambiguously support the diagnosis of acrodermatitis continua suppurativa, immunohistology was performed. The results showed intercellular epidermal fluorescence. The subsequent clinical picture (vegetating formation), the repeated histological examination (suprabasal cleft and eosinophilia), as well as the data of immunohistological findings supported the diagnosis of pemphigus vegetans Hallopeau. The patient was treated successfully with a combination of cyclosporine-A and low-dose steroid therapy. The case is of special interest, because there is only a single publication about phalangeal and nail involvement in Hallopeau's type pemphigus vegetans in the dermatological literature according to our knowledge., (Copyright John Libbey Eurotext 2003)

Three years after removal of a primary tumor, spontaneous hematoma developed on the anterior aspect of the chest of a 33-year-old woman. Ultrasound examination verified by histologic findings indicated subcutaneous metastasis. This new type of metastasis with characteristic clinical features has not been mentioned in the literature, and we named it "hematoma-like metastasis." Special care should be taken in examining patients with melanoma and spontaneous hematoma.

Comprehensive, accurate staging has a critical role in planning rational treatment strategies for patients with malignant melanoma (MM). In the present study the authors investigate the value of FDG PET in staging and restaging based on the investigation of 37 high-risk MM patients and compare the results with the one obtained by conventional imaging techniques (X-ray, US, CT, MR and bone scan). Thirty-nine whole body PET scans were carried out. The authors concluded that FDG PET had the highest sensitivity among the imaging methods in detecting distant metastases of MM.

The authors report about a new "lymphatic-mapping" method (by means of patent blue staining) by which it is able to detect regional (sentinel) lymph node, into which the first metastasis is occurred. Experiences were made known with 15 patients. The by "lymphatic mapping" detected and removed sentinel lymph node has an, important role not only in determination of staging, but also in indication of prophylactic block-dissection, too.